The Great NHS Gamble - what have we investigated and why?

Johnston Press Investigations Team

Former Chancellor Nigel Lawson asserted that the National Health Service was as “the closest thing the English people have to a religion”.

The same observation can doubtless be applied to the other parts of the United Kingdom and when the tenets of that faith are suddenly up for revision then its adherents should know.

That is why the Johnston Press Investigation Unit felt it important that we scrutinise each and every one of the 44 Sustainability and Transformation Plans (STPs) that have been drawn up to remodel the NHS across England with the conveniently converging aims of making Britons healthier while plugging a £22bn hole in the health service budget.

Until December, these blueprints for far-reaching reform were carefully kept under wraps and even now far fewer know about them than should.

If you think the title of these documents is less than mouthwatering, try the contents themselves. Even by the jargon-riddled standards of most reports produced to analyse the structure and goals of large organisations, some of the STPs should be rightly accused of setting new standards of impenetrability.

But the future of the NHS is of course too important to be shrouded for long in the obfuscatory language of “affordability challenges” and “risk stratifications”.

Look hard enough in the thickets of small print and the contours can be discerned of a dramatically different NHS - one where hospitals are closed, services trimmed and concentrated but also one where people will be brought closer to their clinicians and encouraged to lead healthier lives.

The desirability and viability of these changes are matters for a critical and informed debate which, until now, has been hobbled by a distinct absence of detail available to the public about what the Government and NHS England’s five-year plan actually means in terms of the service 55 million people will receive - and doubtless eventually the rest of the population in Scotland, Wales and Northern Ireland where the pressures on health services are every bit as real.

Will there still be beds in your community hospital? How far will you have to drive to the nearest A&E unit? How will technology make a difference to treatment of a long term condition such as diabetes or heart disease?

We cannot claim to have found all the answers but our analysis over the coming days will lift the lid on changes which, whether by accident or design, have until now remained largely unknown and untested.

Only then can we decide whether our national religion is going through the sort of reformation we should support or resist.